What's Bothering You?

appointment went well BUT NOW I have to try to get this procedure approved through my primary insurance provider. and the surgeons office told me outright that they only talk to the  primary insurance provider, not secondary.

well my secondary insurance clearly states in their plan guide that they cover gender affirming care. on the other hand, my primary insurance not only says nothing about gender affirming care being covered under any plans, but they also only recently introduced a program that supposedly offers care for LGBT+ individuals, and based on my readings of others' experiences with this, most of the time the phone operators for the insurance company don't even acknowledge that such a program exists at all. not only that, but this insurance company has denied my mum on multiple occasions for surgeries that were most certainly necessary, on the basis that the company deemed them to be "elective" surgeries.

and I have no way of switching the secondary insurance to primary unless my dad just completely drops me from his plan. it's gonna happen anyway in June since I'll be 26. I don't understand why the surgeon's office won't bill secondary insurance anyway.

I haven't even started this process of calling and calling yet, and I'm already so annoyed and frustrated. I've been on the verge of tears all day today and I haven't even started my shift at work yet. my doctors consider this to be medically necessary based on my documentation of gender dysphoria. but I'm sure the insurance company will deny my request because they consider the surgery to be "elective", and I'm sure that appealing it will do nothing (again, based om my mum's past attempts).

and just like that, my hope is basically squashed. I don't know what to do. I'm so tired. and I can't even ask my dad for help because he is definitely not in favour of this. I need help 😞
 
i actually did end up getting an email back just before office hours closed. unfortunately, the in-person appointments aren't available anywhere within travelling distance of me, and they aren't guaranteed through right to choose anyway. i think i'm going to have to stick with the first clinic i wanted and see if i can convince my GP to agree to shared care. she's really nice and listens, i'm just worried a consultant or even the practice itself will stop her from accepting, even though i think it's up to the discretion of individual GPs? (and even if i go private, that needs a shared care agreement anyway if i want the prescription at nhs prices.) i'm still going to have to escalate the issue and file a complaint. it's really tiring, i don't know why they're insisting i can't choose my clinic in the first place. it shouldn't be this much of a fight to exercise my right.
 
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